Gyrostim Operation Guide

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Questions and Answers

What is the first step in turning on the Gyrostim?

Push the green button on the control panel

Calibrate the chair

Start the Gyrostim software

Turn on the switch on the bottom left (correct)

Which of the following steps must be taken when putting a patient in the Gyrostim?

Lower the steps down to the ground before closing the door (correct)

Close the door before adjusting the straps

Adjust the footrest height after the belts are tightened

Tighten the lap belt before the 5 point harness

What does the nomenclature 'A1' stand for in a custom protocol?

Alternating speed

Acceleration at a steady rate

Acceleration of 1 second (correct)

Angled rotation

Which parameter must be checked between reps to ensure patient safety?

Sweatiness of palms Signup and view all the answers

What does the 'RUN Gyrostim' tab allow you to do?

Access basic protocols Signup and view all the answers

What is a key consideration when determining therapy goals with Gyrostim?

Fast phase versus slow phase stimulation Signup and view all the answers

What does 'D1' indicate in the Gyrostim nomenclature?

Deceleration of 1 second Signup and view all the answers

What action should be taken if a patient shows signs of fatigue during Gyrostim therapy?

Take a break and monitor their condition Signup and view all the answers

What is the primary purpose of the basic protocol designed for individuals with ventral striatal gating issues?

To improve reaction time and cognition Signup and view all the answers

During the sinusoidal protocol, what is the main reason for limiting cervical spine involvement?

To avoid sensory mismatches Signup and view all the answers

When should the yaw and pitch protocols be utilized?

As a warm up or light stimulation between sets Signup and view all the answers

What is a recommended starting point for anxious individuals during the basic protocol?

2 non-inverted spins Signup and view all the answers

What does the term 'Velocity Storage' in the context of gyrostim refer to?

Maintaining a constant velocity without acceleration/deceleration Signup and view all the answers

What should be done if a patient can tolerate stimulation during the All canals protocol?

Try without fixation at increasing speeds Signup and view all the answers

What is the intended outcome when patients engage in dual tasking during the basic protocol?

To enhance cognitive function and engagement Signup and view all the answers

Match the protocols with their primary purpose:

Basic Protocol = General visual/vestibular stimulation, increasing reaction time Yaw = Improves gaze stability for horizontal eye movement pathology Pitch = Improves gaze stability for vertical eye movement pathology Sinusoidal = Isolates visual/vestibular stimulation, limits C-spine involvement Signup and view all the answers

Match the canal focus with their associated eye movements:

R anterior canal = Forward pitch and left yaw L anterior canal = Forward pitch and right yaw RALP Canal = Specific canal designated for treatment LARP Canal = Specific canal designated for treatment Signup and view all the answers

Match the Gyrostim characteristics with their functions:

Constant velocity = Allows for consistent testing without acceleration Spin 360 degrees = Focus on specific canal during treatment Eyes fixated on target = Promotes gaze stability during stimulation Gentle stimulation = Encourages gradual adaptation for patients Signup and view all the answers

Match the nomenclature elements with their meanings in Gyrostim protocols:

VS = Velocity Storage 5 RPM = Rotations per minute A1 = Acceleration of 1 second D1 = Deceleration of 1 second Signup and view all the answers

Match the clinical considerations with their appropriate actions:

Check HR = Monitor heart rate and signs of fatigue Assess eye mm = Facilitate eye muscle response Facilitate presynaptic pools = Use time in between reps effectively Adjust stimulation = Determine patient tolerance level Signup and view all the answers

The nomenclature '5 RPM' in a custom protocol indicates the ______ per minute setting.

rotations Signup and view all the answers

The basic protocol is beneficial for individuals who have ______ striatal gating issues.

ventral Signup and view all the answers

The basic protocol combines head-eye integration and multiple ______ cancellations.

VOR Signup and view all the answers

What is the purpose of the Activate Mirror option?

To make both hands move like the dominant hand Signup and view all the answers

Freeze Motor Hand allows both hands to move freely without restrictions.

False Signup and view all the answers

What bodily posture should be maintained while using the balance platform?

Keep the body straight and do not bend at the waist, hips, or knees. Signup and view all the answers

The ___ duration determines how long the platform holds the tilt.

sustain Signup and view all the answers

In the Optical Flow program, what effect does a negative speed have?

Leads to posterior translation Signup and view all the answers

Match the following settings with their potential effects:

Max Tilt Angle = Increases or decreases platform tilt challenge Pause Duration = Affects difficulty between tilts Tilt Duration = Adjusts the time to reach the tilt Movements = Changes movement directions for patient needs Signup and view all the answers

Tilt mode is the preferred method for warm-up before starting impulsions.

True Signup and view all the answers

What type of stimulation is Optical Flow used for?

Visual flow and downregulating visual system. Signup and view all the answers

What is the primary purpose of the Motion Platform in the Virtualis system?

Where the patient stands for most therapies Signup and view all the answers

The Xbox Controller is required for the Bell’s Test module.

False Signup and view all the answers

What option should be selected to begin a therapy session?

Start a Session Signup and view all the answers

To calibrate the floor in the Virtualis system, set it to _____ inches.

8 Signup and view all the answers

Which of the following is NOT used with the Virtualis system?

Joystick Signup and view all the answers

Match the equipment with its correct function:

Motion Platform = Patient's standing platform Headset = Visual immersion for therapy Vive Controllers = Interactive input for modules Base Stations = Track headset position Signup and view all the answers

What action is performed to finish a therapy session?

Press Enter Signup and view all the answers

In the Bell's Test, what does the environment setting control?

Difficulty and visual processing challenges Signup and view all the answers

What is the primary purpose of using the 'Mirror' setting during therapy?

Facilitate pain relief in chronic conditions Signup and view all the answers

Increasing the speed setting during head-eye coordination practice should be done right from the start.

False Signup and view all the answers

What visual element should be used for the control hand in the Mirror setting?

Choose a color closest to the patient's hand. Signup and view all the answers

The primary purpose of the Electrical Track is to facilitate ______ movement and motor control.

upper extremity Signup and view all the answers

Match the settings to their descriptions in head-eye coordination therapy:

Shapes = Progressively complex visual patterns ROM = Increases shape distance Speed = Initial focus on smoothness Reticle Size = Adjusts the size of the circle shown Signup and view all the answers

Which setting is essential for creating the visual effect that shows the left hand moving when the right hand is used?

Activate the Mirror Signup and view all the answers

What is the recommended initial position for patients during head-eye coordination exercises?

Seated Signup and view all the answers

The 'Radius' setting should always remain the same regardless of patient difficulty.

False Signup and view all the answers

Which of the following purposes is associated with the Optokinetic training?

Visual flow training Signup and view all the answers

The speed setting on the motion platform only allows for positive values.

False Signup and view all the answers

What should you tell patients to do if they feel dizzy during training on the motion platform?

Let me know and we can stop. Signup and view all the answers

The Subjective Visual Vertical (SVV) training uses a red line on the screen and a ___________ to turn the line in different directions.

controller Signup and view all the answers

Match the following training types with their primary purpose:

Optokinetic = Visual flow training Subjective Visual Vertical = Perceptual orientation testing Bird VR = Weight shifting training Platform Difficulty = Adjust platform movement intensity Signup and view all the answers

What adjustment can be made to increase the difficulty of the circles in the Bird VR training?

Decrease circles size Signup and view all the answers

The environment for the Optokinetic training can be customized with different visual settings.

True Signup and view all the answers

In the Optokinetic training, moving the horizontal orientation to a degree to match your angle requires a change to __________ degrees for vertical adjustments.

90 Signup and view all the answers

What is the primary purpose of the butterflies task in therapy?

Enhancing ATNR reflex and visual tracking Signup and view all the answers

The 'Very Hard' setting in the butterflies task allows for targets with a preview of pathing.

False Signup and view all the answers

What type of training does the Limits of Stability Rehabilitation (LOS) focus on?

Weight shifting training Signup and view all the answers

In the Limits of Stability Rehabilitation, increasing the ______ size makes the task easier.

objective Signup and view all the answers

In the skiing exercise, what is the primary variable adjusted to change performance difficulty?

Forward speed Signup and view all the answers

Match the following therapy settings with their respective difficulty levels in the butterfly task.

Very Easy = Target is right in front and doesn’t move Easy = Target appears slightly left/right Medium = Target is further away Hard = Target path is not visible Signup and view all the answers

Patients must maintain a fixed position without any movements in the LOS rehabilitation.

False Signup and view all the answers

What should a patient do in the Limits of Stability Rehabilitation when they see a flower?

Sway in the direction of the flower and hold position until it disappears. Signup and view all the answers

Study Notes

Gyrostim Operations

Power on by using the switch on the bottom left and switching on the computer.
Activate the Gyrostim by pressing the green button on the control panel and starting the software; proceed to calibrate and center the chair.
To turn off, shut down the software and computer, and set up the Gyrostim for the next use (harness and belts).

Setting Up the Patient

Ensure all straps are unfastened and the steps are raised before the patient enters.
Instruct the patient to enter carefully and adjust the shoulder strap height as necessary.
Secure the 5-point harness and lap belt tightly, adjust the footrest so that knees are elevated slightly over thighs.
Position the patient’s feet together against the backrest and secure the feet belt before lowering the steps and closing the door.

Program Usage

Create a new patient profile or select an existing one from the “Subject Information” tab.
Input mandatory details (last name, first name, gender, birthday, dominant hand) when creating a new profile.
Use the “RUN Gyrostim” tab for standard protocols or the “RUN Custom” for tailored protocols.

Custom Protocols Nomenclature

Follow specific nomenclature for custom protocols for effective therapy, e.g., VS LA 5 RPM A1 D1 R1.
Each element reveals details: velocity, speed (RPM), acceleration, deceleration, and rotation specifications.

Clinical Considerations

Gyrostim is designed for specific visual vestibular stimulation; establish goals before therapy begins.
Assess therapy intent: OPK stimulation, eye muscle facilitation, and determining stimulation phase speed (slow or fast).
Consider patient tolerance to stimulation, either x0 or x1.

Basic Principles

Monitor patient well-being before, during, and after spins; check heart rate, signs of fatigue, and temperature.
Utilize rest periods effectively for enhancing presynaptic pool facilitation.
Incorporate complex movements, diverging and specific eye movements into the therapy.
Commence with 1 spin, gradually increasing to 2-3 spins based on patient's response; alternate speed and repetitions.
Recommended therapy duration is 10-20 minutes; note appointments on the sign-in sheet.

Basic Protocol

Ideal for patients with ventral striatal gating issues (e.g., emotional instability, functional neurological disorders).
Aims to enhance visual and vestibular integration; utilize head-eye coordination and various vestibulo-ocular reflex (VOR) techniques.
Begin with mild stimulation for anxious patients, progressively increasing duration and complexity, involve cognitive tasks for engagement.

Sinusoidal Training

Focuses on isolating visual/vestibular stimulation, minimizing cervical spine involvement to avoid sensory mismatches.

Yaw and Pitch Exercises

Yaw: Enhances gaze stability and helps with horizontal eye movement disorders; ideal as a light warm-up.
Pitch: Targets vertical eye movement stability; also suitable as an initial warm-up.

RALP/LARP Canal Plans

Individual patient assessment is essential to determine which canal needs more focus; direct the patient's gaze towards a target in the Gyrostim during 360-degree spins.

Velocity Storage Protocol

Maintains constant spinning velocity without acceleration, crucial for evaluating vestibular function.
Focuses on stimulating weak eye muscles and activating brainstem integrators.
Begin stimulation with a fixation point at slow speeds, gradually advance speed and incorporate problem-solving tasks for patients who tolerate the initial session.